A Solitary Abscessed Hydatid Cyst of the Buttock: A Rare Case.

The hydatid cyst is a cosmopolitan parasitic infection caused by tapeworms of the genus Echinococcus and is a major public health problem in developing countries. Solitary hydatid cysts located in the buttocks are very rare, and the unusual location of the cyst can aid in the differential diagnosis of subcutaneous masses in this area, particularly in endemic areas. In this report, we present the case of a 39-year-old man who was admitted to the emergency department with a painful, abscessed cyst in the buttock region. The cyst was completely excised, and histopathological examination confirmed the diagnosis of a hydatid cyst. Further investigations did not reveal any other locations. Although the buttock region is an extremely rare site of infection for a hydatid cyst, it should be considered in cystic lesions, especially in endemic areas.

Isolated Splenic Tuberculosis in an Immunocompetent Patient: A Rare Case.

Tuberculosis (TB) is one of the top 10 causes of death worldwide and the leading cause of death from a single infectious agent. Despite early diagnosis and improvements in medical science, the incidence of the disease is still a major public health problem in developing countries. Splenic tuberculosis is quite rare and occurs mostly as a part of miliary tuberculosis in individuals with immunosuppression. Isolated splenic tuberculosis is extremely rare in immunocompetent patients. We report a case of an immunocompetent man with isolated splenic tuberculosis.

[Transudative myelomatous pleurisy revealing pleural localization of primary plasma cell leukemia]. / Pleurésie myélomateuse transudative révélant une localisation pleurale d'une leucémie à plasmocytes de novo.

Primary plasma cell leukemia (PPCL) is an aggressive and rare variant of multiple myeloma (MM), with frequent extramedullary involvement, mainly liver and splenic lesions. Pleuropulmonary involvement has rarely been described in the literature. We report a case of primary plasma cell leukemia in a 46-year-old patient, whose first symptom was pleural effusion with mediastinal adenopathies simulating a pleural localization of a lymphomatous process. However, blood smear examination, electrophoresis as well as immunofixation of plasma proteins and immuno-histochemistry have helped to guide the diagnosis. Pleurisy is a rare mode of revelation of plasma cell leukemia and is a factor of poor prognosis.

Predictors of maternal mortality in institutional deliveries in Nigeria.

BACKGROUND: Maternal mortality in poor countries reflects the under-development in these societies. Global recognition of the burden of maternal mortality and the urgency for a reversal of the trend underpin the Millenium Development Goals (MDGs). OBJECTIVE: To determine risk factors for maternal mortality in institutional births in Nigeria. METHOD: Twenty one health facilities in three states were selected using stratified multi-stage cluster sampling strategy. Information on all delivered mothers and their newborn infants within a three-month period was culled from medical records. RESULTS: A total of 9 208 deliveries were recorded. About one-fifth (20.5%) of women had no antenatal care while 79.5% had at least one antenatal visit during pregnancy. Four-fifths (80.5%) of all deliveries were normal deliveries. Elective and emergency caesarean section rates were 3.1% and 11.5% respectively. There were 79 maternal deaths and 8 526 live births, giving a maternal mortality ratio of 927 maternal deaths per 100 000 live births. No antenatal care, parity, level of education, and mode of delivery were significantly associated with maternal mortality. Low maternal education, high parity, emergency caesarean delivery, and high risk patients risk independently predicted maternal mortality. CONCLUSION: Meeting goal five of the MDGs remains a major challenge in Nigeria. Multi-sectoral approaches and focused political will are needed to revert the high maternal mortality.

[Bisphosphonate-associated osteonecrosis of the jaw]. / Bisphosphonatassoziierte Osteonekrose des Kiefers.

BACKGROUND: Bisphosphonates (BP) are widely used in patients with osteoporosis or malignant tumors with bony metastases such as breast cancer and plasmocytoma because of their potency to affect osteoclasts and bone resorption. Osteonecrosis of the jaw (ONJ) has been described as a potential side effect since 2003. After a review of the literature we present results of a questionnaire, which was sent to departments of oral and maxillofacial surgery (OMFS) in German-speaking countries. MATERIAL AND METHODS: We present 349 patients from the literature, 54 patients from the departments of OMFS and 19 cases from our own department. These patients ware analyzed depending on their disease, their medication, localization of the affected area, histological signs and therapeutic outcome. RESULTS: Of 73 patients, 68 (93%) were treated with pamidronate or zoledronate; 69 (94%) patients suffered from malignant diseases, 3 (5%) had osteoporosis, and 1 (1%) had Paget's disease. In 57 (78%) patients the ONJ affected the mandible, in 12 (16%) the maxilla and in 4 (5%) both jaws. A previous tooth extraction was reported in 38 (52%) patients, and in 35 (48%) ONJ occurred spontaneously. Histological findings were similar to osteomyelitis with a high number of actinomyces colonies. Nine (12%) patients received non-surgical treatment only, 52 (71%) patients underwent minor surgical procedures (e. g. decortication) and 19 (26%) patients underwent marginal or segmental resection of the jaw. Considering all treatment modalities, healing was achieved in 55; the most effective was marginal and segmental resection (88%). DISCUSSION: Though millions of patients receive BP treatment only a few suffer from ONJ. The incidence in cancer patients with pamidronate and zoledronate therapy is 4%-10%. Because of the similarity to "phossy jaw", seen in patients dealing with white phosphorus in the nineteenth century, some authors call the new entity "bis-phossy jaw". As the pathogenesis of ONJ is not clear we recommend that the descriptive term bisphosphonate-associated osteonecrosis should be used. Bone resection and safe soft tissue closure is the treatment of choice. We recommend systematic dental care for patients receiving BP medication. Information exchange between oncologists, oral and maxillofacial surgeons and dentists is important.

[Glandular odontogenic cyst of the mandible. Case report]. / Glanduläre odontogene Zyste des Unterkiefers. Ein Fallbericht.

BACKGROUND: Glandular odontogenic cyst (GOC) is a rare lesion of both, the maxilla and mandible, leading to extensive osteolysis. Histologically, it shows thin layers of squamous and cylindrical cells, lined with mucinous metaplasia. This makes it difficult to differentiate from a mucoepidermoid carcinoma. The recurrence rate is high. CASE REPORT: During a routine X-ray examination we saw massive osteolysis of the whole mandible in a 30-year-old female. All teeth were vital. The biopsy taken showed a benign cyst although the clinical aspect was similar to an ameloblastoma. The cyst was removed after intravital fixation with Carnoy's solution. The bony cavity was left without filling material. Uneventful bony healing occurred. DISCUSSION: Due to rare occurrence and similarity to botryoid odontogenic cyst and low-grade mucoepidermoid carcinoma GOC is difficult to identify. It remains without clinical signs for years and is identified in routine X-rays in most cases. We recommend cystectomy after use of Carnoy's solution for intravital fixation. No filling material is required for complete bony healing.

[Von Hippel-Lindau disease: atypical presentation]. / Enfermedad de von Hippel-Lindau: una presentación atípica.

OBJECTIVE: To describe an atypical presentation of von Hippel-Lindau disease. MATERIAL AND METHODS: We present the clinical, diagnostic and treatment of the urological signs of this disease, which has overcoat a neurological management, in a young man with familiar history of it. CONCLUSIONS: The basic knowledge of the von Hippel-Lindau disease is important for the urologist because the urological signs of it, are common and they make up one of the most important causes of morbility and mortality.

[Inflammatory pseudotumor of the urinary bladder]. / Pseudotumor inflamatorio vesical.

OBJECTIVE: To present a new case of inflammatory pseudotumor of the urinary bladder. MATERIAL AND METHODS: We describe the clinical, diagnostic and treatment of a new case of inflammatory pseudotumor of the urinary bladder in a 22 years old man without urological history. CONCLUSIONS: The inflammatory pseudotumor of the bladder is a rare benign lesion of unknown etiology. The most important histopathological differential diagnosis to consider is the rabdomyosarcoma. The immunohistochemistry study is basic in the diagnostic, characterization and differentiation of both pathologies. His benign development force us to a conservative management always it is possible.

Enfermedad de Von Hippel-Lindau: una presentación atípica / Von Hippel-Lindau disease: an atypical presentation

OBJETIVO: Describir una presentación atípica de la enfermedad de von Hippel-Lindau. MATERIAL Y MÉTODO: Presentamos la clínica, diagnóstico y tratamiento de las manifestaciones urológicas de esta enfermedad, de índole mayormente neurológica, en un varón joven con antecedentes familiares de la misma. CONCLUSIONES: Es importante para el urólogo el conocimiento básico de la enfermedad de von Hippel-Lindau porque las manifestaciones genitourinarias de ella son frecuentes, y constituyen una de las causas predominantes de morbi-mortalidad (AU)

Pseudotumor inflamatorio vesical / Inflammatory pseudotumor of the urinary bladder

OBJETIVO: Presentar un nuevo caso de pseudotumor inflamatorio vesical. MATERIAL Y MÉTODOS: Se describe la clínica, diagnóstico y tratamiento de un caso de pseudotumor inflamatorio de localización vesical en un varón de 22 años sin antecedentes urológicos de interés. CONCLUSIONES: El pseudotumor inflamatorio es una lesión benigna poco frecuente y de etiología desconocida. El principal diagnóstico diferencial morfológico es el rabdomiosarcoma vesical. El estudio inmunohistoquímico es fundamental en el diagnóstico, caracterización y diferenciación de ambas patologías. Su carácter benigno obliga a un tratamiento conservador siempre que sea posible (AU)

Rheological characterization of hair shampoo in the presence of dead sea salt.

In Jordan, a growing industry has been established to produce different types of Dead Sea (DS) cosmetics that have DS salt (contains mainly NaCl, KCl, and MgCl(2)) in their formulas. In this work, the effect of DS salt on the rheology of hair shampoo containing the sodium lauryl ether sulfate as a main active matter was studied. The effects of DS salt and active matter concentration, and the temperature and time of salt mixing, on the rheological properties of hair shampoo were investigated. The salt-free shampoo showed a Newtonian behavior at 'low active matter' (LAM) and shear thinning at 'high active matter' (HAM). The presence of DS salt changed the rheological behavior of LAM shampoo from Newtonian (for the salt-free shampoo) to shear thinning. On the other hand, the behavior of HAM shampoo switched from shear thinning to Newtonian behavior in the presence of high concentration of DS salt. The addition of DS salt increased the apparent viscosity of shampoo to reach a maximum value that corresponded to a salt concentration of 1.5 wt.%. Further addition of DS salt led to a decrease in the shampoo viscosity to reach a value less than that of the salt-free sample at high salt concentration. Changing the mixing temperature (25-45 degrees C) and mixing time (15-120 min) of DS salt with shampoo has no significant influence on the rheological behavior. However, the mixing process increased the apparent viscosity of salt-free shampoo. The power law model fitted well the flow curves of hair shampoo with and without DS salt.

The percentage of free prostatic-specific antigen is also useful in men with normal digital rectal examination and serum prostatic-specific antigen between 10.1 and 20 ng/ml.

OBJECTIVE: The percentage of free prostatic-specific antigen (PSA) has been introduced as a tool to avoid unnecessary biopsies in men with normal digital rectal examination (DRE) and serum PSA between 4.1 and 10 ng/ml. In this series we also analyze its utility in men with normal DRE and serum PSA between 10.1 and 20 ng/ml. MATERIALS AND METHODS: A series of 1149 consecutive men with normal DRE and serum PSA between 4.1 and 20 ng/ml submitted for the first ultrasound guided sextant biopsy is analyzed. In 921 (80.2%) the serum PSA was from 4.1 to 10 ng/ml and in 228 (19.8%) from 10.1 to 20 ng/ml. Total and free serum PSA determinations were done by the inmunoradiometric assays Tandem and Tandem free PSA (Hybritech Inc.). RESULTS: The overall detection rate of prostate cancer was 27.9%. In the group of men which serum PSA ranged from 4.1 to 10 ng/ml the rate of detection was 25.4% and 37.7% when it was between 10.1 and 20 ng/ml. Using 25% or less of percent free PSA as a criterion for performing prostatic biopsy it would have detected 95.3% and 95.4% of the prostate cancers, respectively. The rate of unnecessary avoided biopsies would be 17.5% when serum PSA ranged from 4.1 to 10 ng/ml and 17.6% between 10.1 and 20 ng/ml. CONCLUSIONS: This prospective study demonstrates that the percentage of free PSA seems to have similar utility when serum PSA levels are between 4.1 and 10 ng/ml and between 10.1 and 20 ng/ml, at the time of the first prostatic biopsy indication.

Productive infection of primary human endothelial cells by pig endogenous retrovirus (PERV).

The potential risk of viral transmission in the setting of xenotransplantation has gained major attention. Different porcine cell types have been shown to release retroviral particles, which are infectious for human cell lines in vitro. However, there are only a few data on whether PERV (pig endogenous retrovirus) is able to infect primary human cells. In this study we have analyzed endothelial cells, vascular fibroblasts, mesangial cells, mononuclear cells, hematopoetic stem cells and bone marrow stromal cells for PERV transmission. We now provide evidence for primary human endothelial cells, vascular fibroblasts, and mesangial cells to be susceptible to PERV transmission. PERV infection was productive in endothelial cells and mesangial cells. Our data confirm and extend former reports concerning the PERV infection of human cells. The PERV infection of different primary human cells represents further significant evidence for a viral risk during xenotransplantation. In this context, special attention should be directed towards productive infection of human endothelial cells: in the setting of xenotransplantation this cell type will have close contact with porcine cells and PERV particles.